Spine & Sports: Ankle sprains explained

Tuesday

May 13, 2014 at 12:54 PMMay 13, 2014 at 1:03 PM

Inversion sprain to the outside, or lateral ankle, is one of the most common injuries among athletes. Lateral ankle sprain (LAS) inflicts us bipeds simply by virtue of the fact that when we walk or run, we land on one foot at a time. Going down stairs, for example, imparts the weight of our entire body to the ankle with every step.

The ankle joint has three main bony components: the lower part of the leg bones (tibia and fibula), the heel bone (calcaneus) and a bone in the middle (talus). Also, the leg has muscles in front and in back and on the left and right side. Each one wraps around the ankle, steering it in the same way that reins steer a horse's head. These muscles engage each time the ankle receives our body weight (for example, when going down stairs), and they also partially hold the three ankle bones in place and control their motion.

When the ankle bones get stuck or get loaded in the wrong position, they send signals to the body's central nervous system: the spinal cord. The cord reads the situation and reacts to the problem by shutting down some of the leg muscles. Without steering guidance from the muscles, the ankle bones take the path of least resistance and give out, suddenly turning inward and wrenching the outside of the ankle.

In many cases, a sprain causes a jolt with very little pain and quick recovery. Those less fortunate will completely tear the ligaments that hold the bones together. Swelling and bruising is common, and the inflammation that ensues is a natural part of the healing process. We wouldn't have survived as a species without it, so don't try to stop it.

The problem after an ankle sprain is the loss of the up motion, called the dorsiflexion range of motion. Often it is because the talus bone of the ankle pops forward, gets stuck, and loses its ability to glide under the leg bones on ankle dorsiflexion. If not corrected, the ankle remains vulnerable to being sprained over and over again.Chronic, recurrent ankle sprains can often be prevented or cured by expert joint manipulation to the talus bone, resetting it back in place (so to speak). All sports chiropractors are trained to perform this manipulation to the ankle and can comfortably do so even when the ankle is swollen.

Other methods can help the sprained ankle heal, including soft tissue massage, laser therapy and kinesiology tape. Movement and balance exercise is helpful, even with severe sprains, and rehab should begin on day one, with small amounts of movement. Simply placing the foot on a basketball (for example) and rolling it around with control is better than doing nothing. When able, standing and balancing, beginning with solid ground, and progressing to wobble boards or BOSU is the progression. No longer in favor is prolonged ice applications. It will impair the healing process and lead to long-term problems. Much of the self-care rehab process for ankle sprains is easy to find online.

For the best results after an ankle sprain, get your ankle adjusted by a sports chiropractor and then begin your rehab right away. Better yet, get your ankles mechanics evaluated and fixed before you challenge it with your activities.

Scott Gillman is a doctor of chiropractic in Natick, in practice since 1991. He is also a chiropractic sports medicine specialist with a Diplomate from the American Chiropractic Board of Sports Physicians. He can be reached at 508-650-1091 or through www.drgillman.com.

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